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Related Concept Videos

Spinal Nerves: Plexus II01:21

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The plexuses of the lower body include the lumbar, sacral, and coccygeal plexuses, which innervate the abdomen, pelvis, legs, and coccygeal region. These plexuses control the transmission of sensory information and coordinate motor functions of the lower body.
The Lumbar Plexus
The lumbar plexus is situated within the lumbar region of the back and is primarily formed by the first four lumbar spinal nerves (L1 to L4). This plexus extends its branches into several nerves, including the...
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Identifying lumbosacral plexus nerve root abnormalities in patients with sciatica using 3T readout-segmented

Osamah M Abdulaal1,2, Allison McGee3, Louise Rainford3

  • 1Diagnostic Radiology Technology, College of Applied Medical Sciences, Taibah University, Madina, Saudi Arabia. oabdulaal@taibahu.edu.sa.

Insights Into Imaging
|April 20, 2021
PubMed
Summary

Diffusion Weighted Imaging (DWI) with the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence shows promise for detecting lumbosacral nerve abnormalities in sciatica patients. This DWI-RESOLVE method accurately identifies lumbar nerve issues correlating with patient symptoms.

Keywords:
Evidence-based practiceMagnetic resonance imagingSciaticaSpine

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Area of Science:

  • Radiology
  • Neurology
  • Medical Imaging

Background:

  • Sciatica, characterized by lower limb radicular pain, often stems from lumbosacral nerve abnormalities.
  • Accurate detection of these abnormalities is crucial for effective diagnosis and treatment.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of Diffusion Weighted Imaging (DWI) using the Readout Segmentation of Long Variable Echo-trains (RESOLVE) sequence.
  • To assess the efficacy of DWI-RESOLVE in detecting lumbosacral nerve abnormalities in patients presenting with sciatica.

Main Methods:

  • Prospective study involving 110 patients with sciatica-type symptoms undergoing 3T MRI with DWI-RESOLVE sequence.
  • An additional 17 patients with sciatica underwent both neurophysiological testing (EMG/NCV) and DWI-RESOLVE MRI.
  • Two independent radiologists evaluated MR images, assessing nerve size and signal intensity; SNR and ADC values were measured.

Main Results:

  • DWI-RESOLVE detected lumbosacral nerve abnormalities correlating with symptoms in 36.3% of patients without EMG/NCV.
  • Detection rates were comparable to EMG/NCV testing (41.2%).
  • Excellent inter-observer agreement (κ 0.87–0.94) was achieved; significant differences in SNR and nerve size were noted for L5 and S1 nerves.

Conclusions:

  • The DWI-RESOLVE sequence demonstrates potential as an accurate tool for detecting and localizing lumbar nerve abnormalities.
  • This advanced imaging technique may improve diagnostic capabilities for sciatica patients.